Provider Demographics
NPI:1891059424
Name:NEWKIRK, REBECCA L (LMSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 ACADEMY RD NE STE 2-200
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3380
Mailing Address - Country:US
Mailing Address - Phone:505-262-9391
Mailing Address - Fax:505-265-7860
Practice Address - Street 1:7801 ACADEMY RD NE STE 2-200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-262-9391
Practice Address - Fax:505-265-7860
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-089231041C0700X
VA09040102561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical